News about our knowledge of the brain and behavior
from Anthony Risser, Ph.D.

Tuesday, August 22, 2006

Somatization Disorder

From today's New York Times:

Doctors Give Hope to Patients With Long Histories of Unexplained Symptoms By DAN HURLEY22 August 2006

People with a long history of medically unexplained symptoms — aches, pains, fatigue, dizziness and other complaints for which doctors can find no physical cause — might finally find relief.

Two new studies by researchers who specialize in the baffling condition called somatization syndrome, estimated to affect up to 3 percent of adults, suggest that the quest for a physical explanation may take on a destructive life of its own. Instead, those with the syndrome should focus on practical strategies to regain normal function and relieve symptoms, the researchers say.

One study, by German scientists, sought to explain why the doctors’ reassurances were generally ineffective with such patients. The researchers played taped comments by a doctor about a hypothetical patient for two groups of participants, people who had the syndrome and people who did not. Those with somatization syndrome were three times as likely to believe incorrectly that in the course of the comments the doctor had said the symptom had a worrisome physical cause.

The findings, in the August issue of the online journal Public Library of Science Medicine, offer at least a partial explanation for why patients often go from doctor to doctor and take test after test in a fruitless search for answers: repeated reassurances are simply not being understood.

A second study, by New Jersey researchers, provides the first published evidence of an effective clinical treatment. The study, in the July 24 issue of The Archives of Internal Medicine, found that patients benefited from 10 sessions of cognitive behavioral therapy specifically organized to help relieve their stress and increase emotional awareness and to get them to become more socially active and think differently about their symptoms.

1 Comments:

Anonymous said...

In the history of medicine when causes of illness are unknown it is a habit to psychologise. The psychological correlates are accepted without rigorous empirical thought and experimentation. Usually meta-analyses of available research prove inconclusive. This tendency has resulted in the concept of somatization disorder being used to avoid effective, albeit difficult research into elusive causes. Most recently I have seen this with "IEI", Chronic Fatigue Syndrome and Fibromyalgia Syndrome. There is no doubt in my experience that CBT is a useful treatment for these illnesses but that doesn't support the theory of Somatisation.

These disabling illnesses carry with them pain, fatigue, nausea and other very unpleasant symptoms which are affected by anxiety about the illness, fear of not coping and maladaptive action. At least CBT is better than "the doctors reassurances". How can any Medical Practitioner give assurances about an illness which makes a person feel gravely ill and can give no explanation as to why. Especially when Psychological attributions are no better confirmed than any other.